{"id":117,"date":"2014-11-15T13:07:22","date_gmt":"2014-11-15T13:07:22","guid":{"rendered":"http:\/\/leadingachildrenshospital.com\/?p=117"},"modified":"2015-05-06T18:01:36","modified_gmt":"2015-05-06T18:01:36","slug":"whos-on-first-whats-on-second-and-i-dont-know-whos-on-thirdyes-thats-correct","status":"publish","type":"post","link":"https:\/\/leadingachildrenshospital.com\/?p=117","title":{"rendered":"Who\u2019s on first, What’s on second and I don\u2019t know who\u2019s on third"},"content":{"rendered":"

Who\u2019s on first?<\/strong> \u2013 Is it the patient? \u00a0The doctor? \u00a0The hospital? \u00a0The payer? In our everyday clinical (and non-clinical) practice we need to remind ourselves it’s the patient. When the patient is first, safety is first, quality is first, the care experience is first, and access is first. \u00a0Soon cost will be more of a consideration as individuals become increasingly responsible for the cost.<\/p>\n

What\u2019s on second?<\/strong> \u2013 If the patient\u2019s on first, then what\u2019s on second?\u00a0Is it the doctor? The hospital? The payer? \u00a0 It must be one of those, right? Wrong. Knowledge, information, and data are on second. It’s a huge \u201cWhat\u201d in health care and we\u2019re not so good at managing, using and communicating it. \u00a0We simply have to get better at it. It will take technology and its proper application to disrupt our current system. There is good news. \u00a0We’re on the early part of the slope.<\/p>\n

I don\u2019t know who\u2019s on third<\/strong> \u2013 Yes, we often don’t know and it\u2019s a problem. \u00a0Once again, it\u2019s not the doctors, the payers or the hospitals. \u00a0Culture is on third. \u00a0Culture defines and drives performance. And most of us don\u2019t know much about it or how to influence it, let alone manage it. Culture is the end result of the behaviors, processes, strategies, values and visions put forth by leadership. \u00a0Its the driver of organizational behavior. \u00a0And culture is really what you are trying to influence when you make decisions and act as a leader. Putting in place a new process isn\u2019t in of itself going to do much. Its what it does to the culture that really matters in the long run.<\/p>\n

Baseball as a metaphor:<\/strong> Health care delivery is a team sport, and each position must be played well for the team to win. The physician, although not \u201con first\u201d is certainly in the position of being captain, or at least the pitcher. The catcher is the advanced practitioner or nurse who helps manage the patients. And there are others on the team that the patient relies on. \u00a0Increasingly we are using medical assistants to assist us in collecting data, navigating patients and monitoring adherence. \u00a0The culture of the team is as important as the competence of each individual. We’ve seen that play out in major league sports time and time again.<\/p>\n

So, what\u2019s the secret sauce for creating a strong culture of excellence and reliability in health care? The evidence would suggest that its leadership. \u00a0I recently suggested in our organization that we have a leadership credo for our clinical transformation initiative. Someone on the work group asked why. \u00a0A fair question. \u00a0The reason is because leadership sets the tone, it’s the key to culture. If the leaders aren\u2019t consistent, reliable, mindful, committed to transformation, committed to our chosen improvement tools, and committed to culture shift, then the effort fails. If we aren\u2019t all rowing in the same direction as leaders, then the effort fails.<\/p>\n

What’s your leadership credo? \u00a0And does each person on your leadership team share and live the same credo?<\/p>\n","protected":false},"excerpt":{"rendered":"

Who\u2019s on first? \u2013 Is it the patient? \u00a0The doctor? \u00a0The hospital? \u00a0The payer? In our everyday clinical (and non-clinical) practice we need to remind ourselves it’s the patient. When the patient is first, safety is first, quality is first, the care experience is first, and access is first. \u00a0Soon cost will be more of […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[4,3],"tags":[],"_links":{"self":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/117"}],"collection":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=117"}],"version-history":[{"count":5,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/117\/revisions"}],"predecessor-version":[{"id":166,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/117\/revisions\/166"}],"wp:attachment":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=117"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=117"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=117"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}